消除了手术前静脉过的必要性:硫酸作为预防HIPEC治疗患者的毒性 - - 追溯分析
Elea Vachez1, Amaniel Kefleyesus2, Naoual Bakrin3
1Department of Gynecology, Lyon-Sud University Hospital, Lyon, France.
概括
硫酸硫酸在高热性腹膜内化学疗法 (HIPEC) 期间有效地预防西斯丁的损伤. 当使用硫酸硫酸时,不需要进行手术前的水合,这简化了腹转移的治疗.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 细胞还原性手术与高热性腹腔内化疗 (HIPEC) 是腹腔内转移的关键治疗方法.
- 基于西斯的HIPEC可以引起显著的毒性.
- 硫酸硫酸 (ST) 已经证明有潜力减轻西斯普拉丁诱导的毒性.
研究的目的:
- 评估硫酸盐 (ST) 在HIPEC期间预防西斯普拉丁诱导的毒性疗效.
- 为了比较治疗毒性的不同方案:单独进行手术前的过水 (PHH),单独使用ST的PHH和单独使用ST.
- 评估这些协议在HIPEC后对急性损伤 (AKI) 和慢性损伤 (CKI) 的影响.
主要方法:
- 对220名患者的回顾性分析,这些患者接受了基于西斯普拉丁的HIPEC (2015-2020) 的治疗意图的细胞减小手术.
- 根据毒性管理对患者进行分组:PHH,PHH + ST或单独ST.
- 在术后3个月内对功能 (血清肌素,GFR) 和损伤 (AKI,CKI) 进行监测.
主要成果:
- 与PHH组相比,PHH + ST和ST单独组的平均血清肌水平明显较低 (p < 0.001).
- 淋巴膜过率 (GFR) 在PHH + ST和单独ST组之间是可比的,但在PHH组中较低 (p < 0.001).
- 与PHH组相比,PHH+ST组和单独ST组的AKI和CKI发生率显著降低 (分别为1%和0%),而PHH组的AKI和CKI发生率分别为21%和19%,p<0.001). 在PHH+ST和单独ST之间没有观察到脏学结局的显著差异.
结论:
- 当施用硫酸硫酸时,不需要进行手术前的过,以防止在接受HIPEC治疗的患者中发生西斯普拉丁诱导的毒性.
- 硫酸盐单独是有效的预防毒性,简化治疗方案.
- 这些发现可以增强接受基于西斯普拉丁的HIPEC的腹膜转移患者的管理.
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